US breast cancer centers recommend earlier initiation of screening

Most U.S. breast cancer centers recommend that women begin screening mammography at an earlier age than recommended by national societies, according to a research letter published online March 15 in JAMA Internal Medicine.

Neal S. Patel, from Weill Cornell Medicine in New York City, and colleagues conducted a cross-sectional study to review recommendations for the starting age and interval of screening mammography on the public websites of 606 U.S. breast cancer centers.

The researchers found that 80.4 percent of the breast cancer centers provided recommendations regarding screening mammography, while 19.6 percent did not provide recommendations. Of the 487 centers that provided recommendations, 88.5, 88.1, and 11.5 percent specified a starting age for screening, specified a starting age and screening interval, and recommended that women discuss screening with their physicians, respectively. Of the 431 centers that recommended a starting age, 87.2, 8.1, and 4.6 percent provided recommendations different from those of national societies by advising that women start screening at age 40 years, recommended screening initiation at age 45 years, and recommended screening initiation at age 50 years, respectively. Overall, 80.9 percent of the centers that recommended a starting age and screening interval provided recommendations that differed from those of national societies, advising that annual screening begin at age 40 years.

"Breast cancer centers with clear financial benefits from increased mammography rates may wish to reconsider offering recommendations that create greater referral volume but conflict with unbiased evidence-based U.S. Preventive Services Task Force guidelines and have the potential to increase harms among women," write the authors of an accompanying editorial.

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